Disruptive Behavior Disorders Clinical Trial
Official title:
A Statewide Trial to Compare Three Training Models for Implementing an EBT
Evidence-based treatments (EBTs) are available for treating Disruptive Behavior Disorders (
DBDs) including Parent-Child Interaction Therapy (PCIT). Despite EBTs' potential to help
children and families, they have primarily remained in university settings. Recognized field
leaders have expressed concern over the discrepancy between treatment research and clinical
practice, and have indicated that EBT implementation is a priority. Little empirical evidence
exists regarding how effective commonly used training models are in changing clinician
behavior, achieving full implementation (e.g., increasing treatment fidelity, integrating
into service settings), and supporting positive client outcomes. This novel application will
evaluate the effectiveness of three training models (Learning Collaborative,
Train-the-Trainer, and Web-Supported Self-Study) to implement a well-established EBT in
real-world, community settings.
To accomplish this goal, the project will be guided by three specific aims:
1. to build knowledge about training outcomes,
2. to build knowledge about implementation outcomes, and
3. to understand the impact of training clinicians using LC, TTT, and SS models on key
client outcomes.
Seventy-two of 243 possible (30%) licensed psychiatric clinics across Pennsylvania will be
randomized to one of three training conditions:
1. Learning Collaborative (LC),
2. Train-the-Trainer (TTT), or
3. Web-Supported Self-Study (SS).
Data also will be collected on staff trained by clinicians in the TTT group given that the
intention of a TTT model is for participants of that group to return to their organization
and train others within the organization. The impact of training (clinician level) will be
evaluated at 4 time-points coinciding with the training schedule: baseline, 6, 12, and
24-months. Immediately after training begins, parent-child dyads (client level) will be
recruited from the caseloads of participating clinicians (N = 288). Client outcomes will be
assessed at four timepoints (pre-treatment, 3, 6, and 12-months). Implementation outcomes
(clinic level) will be assessed at baseline, 6, 12, and 24-months after training. This
proposal builds on an ongoing state-led initiative to implement, and ultimately sustain, PCIT
statewide. Lessons learned from this project will directly impact future EBT implementation
efforts in Pennsylvania and other states, helping to increase the use of EBTs in community
settings nationwide.
n/a
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